Challenges in Undersea

Medicine

CAPT Fred Yeo, MD

Commanding Officer

Naval Submarine Medical Research Laboratory

April 2016

DISTRIBUTION STATEMENT A. Approved for public release.

UNCLASSIFIED 1

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CAPT Fred Yeo, MD, Commanding Officer, Naval Submarine Medical Research Laboratory

William D’Angelo, PhD, Program Officer, Undersea Medicine Program, Office of Naval Research

David Southerland, MD, Acting Program Manager, Deep Submergence Biomedical Development Program, Office of Supervisor of Salvage and Diving, Naval Sea Systems Command

CDR Hugh Dainer, MD, PhD, Department Head, Undersea Medicine Department, Naval Medical Research Center

Panel Members

Office of Naval Research

Undersea Medicine Program

William D’Angelo, PhD

Warfighter Performance Department

Office of Naval Research

April 2016

DISTRIBUTION STATEMENT A. Approved for public release.

UNCLASSIFIED 3

Purpose

To compensate for human shortfalls in operating under water.

• Approach: Enhance human physiology, provide technology

to do so or set appropriate operational limits

• An ONR National Naval Responsibility

Sustain robust international research capability and Navy labs

Cultivate pipeline of scientists and engineers

Provide S&T products that ensure future superiority in the undersea

domain

• Direct and immediate warfighter application

Diving and Salvage: hull repair, recovery, rescue

Special Warfare (SEAL & EOD): stealthy ingress, route clearance

Submarine Force: long missions, confined space, limited senses

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UMed Focus and Pathway

Basic Research Lanes

• Decompression Sickness

• Oxygen Toxicity

• Diver/Submariner Health + Performance

Technical Development

Gas & Membrane

Physiology

Transition Fundamental

Concept

Funding Opportunities

• ONR is the Basic (6.1) and Applied (6.2) research agency

• General submission information for academia and industry

– Fiscal Year Broad Agency Announcement (BAA) • http://www.onr.navy.mil/en/Contracts-Grants.aspx

– Rolling submission throughout fiscal year

• Strong UMed small business program (SBIR/STTR)

– Human factors of technology for divers

– Development of research tools

• Other ONR Funding Opportunities

– Basic and Applied Research Challenge (BRC & ARC)

– Multidisciplinary Research Program of the University Research Initiative (MURI)

– Defense University Research Instrumentation Program (DURIP)

– Young Investigator Program (YIP)

– ONR Global • http://www.onr.navy.mil/en/Science-Technology/ONR-Global.aspx

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Deep Submergence Biomedical

Development Program

David Southerland, MD

Office of the Supervisor of Salvage and Diving

Naval Sea Systems Command

Apr 2016

DISTRIBUTION STATEMENT A. Approved for public release.

UNCLASSIFIED 7

Opinions expressed are my own and are not necessarily those of the Naval Sea Systems Command.

DSBD in a Nutshell

Deep Submergence Biomedical Development (DSBD) Program

An integrated biomedical/bioengineering advanced development

(6.4) R&D effort to enhance U. S. Navy capability in:

Enhancement of Survival of Submariners in a Disabled Submarine

(DISSUB) scenario

Diver Health and Safety

Biomedical Criteria for Diver Equipment/Procedures

Sponsor: CNO-97 Undersea Warfare

Manager: NAVSEA 00CM

Products: 90% Guidance and Procedures

Current projects: 14 (Each runs ~1-3 years)

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• Navy Experimental Diving Unit, Panama City, FL

(NEDU)

• Naval Submarine Medical Research Laboratory,

Groton, CT (NSMRL)

• Naval Medical Research Center, Silver Spring,

MD (NMRC)

• Duke University

• State University of New York at Buffalo

• University of Wisconsin

Current Researchers

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Human

– Nonclinical

– Greater than minimal

risk (usually)

Animal

– Swine

– Sheep

“Researchees”

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• Solicitation - Broad Agency Announcement

– http://www.supsalv.org

--> 00C3 Diving --> Diving R&D BAA

• Pre-Proposal

• Invited Proposal

• Technical Advisory Board (TAB)

– Membership: Operational and technical personnel

– Review and Rank Proposals

• Awards based on ranking and funding available

Award Process

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• DISSUB Submariner Survival

– Shallow air saturation decompression procedures after escape

– Thermal model for dry, humid hyperbaric exposures with no fluid

replacement.

• Diver Health and Safety

– Integrated diving and altitude decompression model

– Helium-Oxygen decompression table update

– Robust CNS oxygen toxicity model

• Biomedical Criteria for Diver Equipment/Procedures

– Tolerable Work of Breathing limits for dry, pressurized exposures

Biomedical Diving Gaps/Deficiencies

(Formal Gap Analyses for Submarine and Diving medicine are currently in progress.)

Biased toward problems I see

Biomedical Research in the

Navy Laboratories: Animal

Models and Advanced

Development

CDR Hugh Dainer, MD, PhD

Department of Undersea Medicine

Naval Medical Research Center

Apr 2016

DISTRIBUTION STATEMENT A. Approved for public release.

UNCLASSIFIED 13

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Areas of Active Research

– Decompression Sickness • Disabled Submarines

• Working Divers

– Oxygen Toxicity • Special Forces

• Chamber Personnel

– Extreme Environments • En Route Care

• Hypobaria

• Hypoxia

Naval Medical Research Center

Department of Undersea Medicine

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Active Undersea Medicine Projects Area of Research Funding

Tiotropium and Pulmonary Oxygen Toxicity Oxygen Toxicity NAVSEA

Channels in High Altitude Cerebral Edema Extreme Environs ILIR

MSK Damage and TBI Extreme Environs ILIR

Model for Drowning Research Extreme Environ ONR

Oxygen Microbubbles Decompression ONR

ARDS and Volatile Organic Compounds Oxygen Toxicity JPC-5

VOC’s in Military Divers Oxygen Toxicity ONR

Heliox Diving – Uncontrolled Ascent Decompression NAVSEA

Pharmacology Altitude Acclimatization Extreme Environs JPC-5

Department of Undersea Medicine

Naval Medical Research Center

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Naval Medical Research Center

Department of Undersea Medicine

Submarine Medicine

CAPT Fred Yeo, MD

Commanding Officer

Naval Submarine Medical Research Laboratory

Apr 2016

DISTRIBUTION STATEMENT A. Approved for public release.

UNCLASSIFIED 17

NSMRL

• Naval Submarine Medical Research Laboratory, Groton CT

• Co-located on the largest submarine base in the US

• Echelon 4 to Bureau of Medicine and Surgery (BUMED)

• NSMRL Mission: Provide innovative human-centric research

solutions aligned with the Submarine Force strategic direction,

to sustain superiority in the undersea domain

• Conduct research across 6.1 to 6.7 domain

• 100% reimbursable lab, $ 9-11 M/year

• Transition products directly to the submarine force

• Sponsors: ONR, NAVSEA, BUMED, NASA, SUBFOR,

• NUWC, USARIEM, VA, others

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NSMRL: areas of research focus

• Submariner health: medical and psychologic

• Aligning submariner medical standards to evidence

• Submarine escape and rescue procedures

• Submariner microbiome

• Hearing conservation efforts

• Resiliency, performance, team resiliency

• Cognitive performance

• Screening and selection of submariners

• Submarine atmosphere and environment

• Submariner epidemiology

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Questions?

For additional questions after the

conclusion of the conference, send

an email message to

usarmy.detrick.medcom-

usamrmc.mbx.mmpd@mail.mil